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NPI Code Detail

MEDICARE: DR. YOUNG D KONG MD

MEDICARE: DR. YOUNG D KONG MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianMA29870NJ

General Provider Information

NPI Number : 1770672412
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. YOUNG D KONG MD
Provider Business Mailing Address
First Line : 97 CENTRAL AVE
Second Line :
City : OCEAN GROVE
State : NJ
Zip : 07756-1137
Country : US
Telephone Number : 732-774-4418
Fax Number :
Provider Business Practice Location Address
First Line : 97 CENTRAL AVE
Second Line :
City : OCEAN GROVE
State : NJ
Zip : 07756-1137
Country : US
Telephone Number : 732-774-4418
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/12/2006
Last Update Date : 07/08/2007

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Directions to “ DR. YOUNG D KONG MD” Practice Location

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